The complex hand

The hand and wrist are frequently used in everyday life making them especially prone to injuries such as dislocations, sprains, and fractures. Together they consist of a large collection of joints, ligaments, bones, tendons, and muscles. This complexity means that specialized medical care is required when an injury occurs.

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Common Hand and Wrist Injuries

Carpal Tunnel

Carpal tunnel syndrome occurs when the major nerve to the hand (the median nerve) becomes compressed or pinched as it passes through the wrist.  This causes symptoms such as tingling, numbness, and pain in the arm and hand. It is also common for the fingers to “fall asleep” at night.

Carpal tunnel is progressive which means that over time it gets worse. Therefore, diagnosing the condition early on and getting treatment are important. If the condition is treated during early onset, the symptoms can be relieved by simply wearing a wrist brace or splint and refraining from certain activities.

If the median nerve is exposed to long term pressure the nerve can become damaged causing the symptoms to worsen. As a result, some cases require surgery in order to relieve pressure on the median nerve.

Ganglions and Cysts

A Ganglion cysts is the most common cause for a lump or mass to form in the area of the hand. It is not known what triggers Ganglion cysts to form. They are most commonly found forming on the back of the wrist but they can also occur in other locations.

Ganglion cysts are like little fluid-filled balloons that quickly appear by rising out of a joint. They can change size rapidly and can disappear just as quickly as they first appeared.

They are usually harmless and will not require medical attention. Treatment becomes an option when a Ganglion cyst begins to interfere with normal function, causes pain, or becomes too large. The most common way to deal with a cyst is to drain the fluid through a procedure known as Aspiration. If the cyst returns after aspiration then surgery may be recommended.

Wrist Sprains

A wrist sprain occurs when ligaments supporting the wrist joint stretch past their limit or tear. This can happen if the wrist bends forcefully such as falling onto a hand that is trying to brace the fall. A sprained wrist is a common injuries that can range anywhere from mild to severe, depending on the severity of the damage sustained by the ligaments.

Sprains are graded by the degree of injury:

  • Grade 1 (mild).  The ligaments are stretched too far but are not torn.
  • Grade 2 (moderate). The ligament sustains significant injury involving a partial tear and possibly some loss of function. A moderate sprain may need to be immobilized with casting or a splint to stabilize the joint.
  • Grade 3 s(severe). The ligaments are completely torn and may be pulled off the attachment to the bone. Severe sprains are significant injuries that often require surgery to repair the torn ligament. It can take from 6 to 12 months for a full recovery.

Flexor Tendon Injuries

Flexor tendons are just under the surface of the skin. Therefore, a deep cut on the palm of your hand is likely to hit a flexor tendon. This injury can make it impossible to operate your thumb or bend your fingers.

Tendons connect the muscle to the bone and are under a rubber band-like tension. When a tendon is torn or cut, the ends will pull far apart. This makes it impossible for the tendon to heal on its own and it must be surgically repaired by a doctor. This procedure is performed within 7 to 10 days after an injury to allow the swelling to go down. Recovery takes up to two months before your hand is strong enough to use without protection.


Wrist Arthroscopy

Arthroscopy refers to the surgical procedure used to examine and treat conditions inside a joint.  The procedure takes its name from the arthroscope which is the miniature fiber optic instrument that is utilized used by the surgeon to see inside the joint. Arthroscopy allows a surgical procedure to be performed on the patient without making large incisions in the tissue and muscle.

The wrist is one of the complex joints in the body.  I consists of eight bones which are connected by several ligaments. Arthroscopic procedures are used to diagnose and treat several common conditions of the wrist such as fractures, chronic pain, torn ligaments and ganglion cysts.

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